SPINAL DEFORMITY

What’s Spinal Deformity?

A normal spine function includes providing fundamental support for standing and sitting upright, walking, bending, and twisting (Diebo et al., 2019). Various structures such as muscles, ligaments, tendons, and bone help to keep the spine strong and safe. The normal spine possesses a structural equilibrium that allows for maximum flexibility and weight support. The normal spine includes three smooth curves when seen from the side. Lordosis refers to the C-shaped inward curve of the lumbar (lower) spine. Kyphosis refers to a reverse (outward) C-shape in the mid-back (thoracic spine) and sacral areas (Moon, Lee, & Kim, 2010). These curves work together to keep the body’s center of gravity aligned over the hips and pelvis. A healthy spine appears straight from the front or rear.

Spinal deformity occurs when the curvature of the spine changes from the normal, graceful S-shape viewed from the side or the straight line down the back of a normal spine. Symptoms of spinal abnormalities include discomfort, weakness, numbness, tingling, loss of function, and pulmonary and cardiac issues. Abnormal curvature usually causes misalignment of the spine. Sagittal imbalance refers to an abnormal curvature perceived from the side. Examples of sagittal imbalance include kyphosis, flat back syndrome, and chin-on-chest syndrome. Scoliosis refers to the abnormal curvature of the spine as seen from the back.

What’s The Common Symptoms and Causes of Spinal Deformity?

Signs refer to the visible indications of a medical condition or disorder. Signs of scoliosis include a variation in shoulder or hip height, a difference in how the arms hang beside the body, a visibly off-center spine, or a head that appears off-center with the body. Additionally, signs of sagittal imbalance include a slumped forward posture, a hump in the back, or the difficulty of standing up straight. Also, the common symptoms of any spinal deformity include loss of sensation, mild discomfort to severe pain, weakness in the legs and arms, etc. Spinal abnormalities might cause problems with the spinal cord or nerve roots. The indicators of stretching or compression of the spinal cord or nerve roots include pain, weakness, numbness, or tingling that travel down an arm or leg (Lenke, 2018). 

Damage to the vertebrae or intervertebral discs, as well as diseases such as osteoporosis, can cause the spine to distort. Due to a malfunction in the genes that regulate spinal growth in the embryo, a person may develop an unnaturally curved spine at birth (known as a congenital spinal deformity). Spinal anomalies can develop later in a child’s life as he or she grows and develops. Other causes of spinal deformity may include accidents, arthritis, spinal tuberculosis, poor posture, muscular dystrophy, etc.

Different Types of Spinal Deformity

Different types of spinal deformities include (Anwer, Alghadir, Abu Shaphe, & Anwar, 2015):

1.   Scoliosis: This condition causes side-to-side curve in the mid-back or thoracic region.
2. Kyphosis (or hyper-kyphosis): This condition refers to an exaggerated forward curvature of the spine. 
3. Spondylolisthesis: This refers to a disorder in which one of the spine’s vertebrae slips out of place, exerting pressure on the disc and nerve below it.

How Do Spinal Specialists Diagnose Spinal Deformity?

Neurosurgeons can clearly observe spinal deformities with the naked eye. Therefore, neurosurgeons will require a brief medical history and further examination to confirm the cause and extent of spinal deformities. Neurosurgeons use the following tests to diagnose spinal deformities (Schwab et al., 2012):

• X-ray: This test uses electromagnetic energy beams to produce images of bone and associated structures. 
• Magnetic resonance imaging (MRI): This test uses radio waves to produce a detailed image of the spinal cord and nerves to see any abnormalities.
• Computed tomography (CT) scan: This diagnostic tool helps to produce 3-dimensional images of bones and tissues by using X-rays and computer technology.
• Electromyogram and nerve-conduction test: This test helps to measure the electrical activity of muscles and nerves to recognize any nerve damages.
• Blood test: Neurosurgeons perform blood test to detect HLA-B27 gene that causes ankylosis spondylitis. 
• Myelogram: Neurosurgeons inject a dye into the spinal column to visualize the structures more clearly with CT scans.

Besides these tests, neurosurgeons also perform pulmonary tests to determine the lung function to detect any abnormalities or compression in the chest due to the spinal deformity.

How Do Neurosurgeons Treat Spinal Deformity?

Neurosurgeons treat spinal deformities to restore the spine’s normal position. Treatment procedures of spinal deformities alleviate any discomfort, weakness, or numbness related with the incorrect alignment. Neurosurgeons usually try conservative treatments first before recommending spinal deformity surgery. Treatment for this condition depends upon the type and severity of deformities. Treatment protocols for spinal deformities may include:

• Monitoring: This includes observing young patients to see the progress of the spinal curve.
• Bracing: This helps to hold the spine in its normal alignment.
• Medications: This involves administering pain relievers to manage pain or corticosteroid injections to reduce the inflammation of the spine. 
• Physical therapy: This involves strengthening the muscles of the back through exercise and lifestyle changes.

If above options fail, neurosurgeons recommend surgery to remove collapsed discs or fuse the misaligned vertebrae. For more information, please contact us.

If You need a Fort Worth Neurosurgeon, Contact Longhorn Brain & Spine Immediately To Get a Consultation.

References

Anwer, S., Alghadir, A., Abu Shaphe, M., & Anwar, D. (2015). Effects of Exercise on Spinal Deformities and Quality of Life in Patients with Adolescent Idiopathic Scoliosis. BioMed Research International, 2015. https://doi.org/10.1155/2015/123848

Diebo, B. G., Shah, N. V., Boachie-Adjei, O., Zhu, F., Rothenfluh, D. A., Paulino, C. B., … Lafage, V. (2019). Adult spinal deformity. The Lancet, 394(10193), 160–172. https://doi.org/10.1016/S0140-6736(19)31125-0

Lenke, L. G. (2018). Clinical Spinal Deformity Research. Spine, 43(7S), S4–S5. https://doi.org/10.1097/BRS.0000000000002547

Moon, M. S., Lee, B. J., & Kim, S. S. (2010). Spinal deformity. Indian Journal of Orthopaedics, 44(2), 123–126. https://doi.org/10.4103/0019-5413.61725

Schwab, F., Ungar, B., Blondel, B., Buchowski, J., Coe, J., Deinlein, D., … Lafage, V. (2012). Scoliosis research society-schwab adult spinal deformity classification: A validation study. Spine, 37(12), 1077–1082. https://doi.org/10.1097/BRS.0b013e31823e15e2